The horror of sexual violence that has blighted the lives of women and girls in DR Congo is nowhere more apparent than at Panzi Hospital, in Bukavu. The first thing that strikes you is the long queue of women.
In some parts of East Congo, three out of four women have been raped during the 14 years of conflict.
Panzi is East Congo’s leading referral hospital for rape survivors, who constitute over two thirds of its patients.
Doctors there began vaginal reconstruction in 1998. Their inaugural patient had been gang-raped by soldiers, who then inserted a rifle into her genital and fired a shot.
In the Great Lakes region, each armed group has their own gruesome hallmarks of sexual violation.
Rape as a weapon of war, terror and ethical cleansing first came to prominence during the Rwandan Genocide and Balkans wars in the 1990s. Rape is used to torture, degrade, intimidate and ultimately defeat and chase away targeted men and women.
In many cases, women’s sexuality is seen as being under the protection of men, so its defilement is an act of domination over the group under attack.
At least 20,000 women were raped in Bosnia-Herzegovina during the war. These women were then denied medication, even if they fell pregnant or ill.
One obvious result of this horrendous sexual violence in conflict is increased risk of HIV. Women in DRC were infected as a direct result of rape at gunpoint.
It’s an issue my fellow campaigners from The International Action Network on Small Arms are highlighting this International Women’s Day.
Last week, we travelled to New York to speak to diplomats at the UN Commission on the Status of Women. We argued that reducing armed sexual violence should be incorporated in HIV prevention strategies.
THE INVOLVEMENT OF A GUN IN AN assault dramatically reduces the victim’s chances of escape. Unlike a knife, for example, a gun can be fired from a distance or used to dominate a whole group.
The exceptional lethal nature of firearms is well acknowledged by injury prevention and security experts, but the connection with sexually transmitted diseases is not yet widely recognised. The presence of a gun can make the difference between escape and severe fright.
And the problems faced by victims of rape in war are manifold and long-lasting. Having suffered the physical and mental anguish of rape, women then face the trauma of being ostracised from the communities which should be rehabilitating them.
In Rwanda, the UN estimates that between 250,000 and 500,000 rapes were committed during the genocide of 1994. Fifteen years later, around seven out of 10 survivors are living with HIV.
One Rwandan survivor testified: “Since I was infected with HIV, my husband divorced me and left me with three children. Now I don’t know how to pay for food, rent, school… my worry is what will happen to my children if I die.”
Discrimination against rape survivors in Rwanda results in many women dying in silence. Children born from such rapes are commonly called enfants mauvais souvenir — children of bad memories.
Many mothers of such children have sold their family land to pay for medication, and the phenomenon of child-headed households is increasing.
Until governments and the UN recognise the link between guns, sexual violence and HIV — and take serious steps towards tackling it — the plight of the most desperate women on earth will remain unheard.
Ms Waruhiu is a member of the Iansa Women’s Network.